Device for improving handling of guiding wires

ABSTRACT

A device ( 1 ) is disclosed to improve handling of a catheter guiding wire ( 6 ) at its proximal end. The device has a base body ( 9, 11 ) with a longitudinal lumen ( 10 ) for receiving the guiding wire ( 6 ), frictional clamping means for clamping the guiding wire in the longitudinal lumen ( 10 ), and an extension ( 11 ) shaped as a hollow needle that extends in the direction of the longitudinal lumen ( 10 ) and that protrudes at the distal and/or proximal end of the base body and is movable in the longitudinal direction in relation thereto. The hollow needle-shaped extension is preferably telescopically collapsible and the clamping means are arranged at the proximal end of the base body ( 9 ) in the longitudinal direction.

BACKGROUND OF THE INVENTION

In ballooning or catheter examinations inside the heart, for example,the balloon catheter or any other catheter is advanced or retracted bymeans of a so-called guide wire inside a guiding catheter previouslyintroduced in the patient. In the monorail type of balloon catheters,the guide wire exits from the wire-receiving lumen of the ballooncatheter about 10 to 30 cm proximally of the baloon (FIG. 1) and thenextends outside, but in parallel with, the balloon catheter shank,within the guide catheter up to the proximal end thereof outside thepatient so that the surgeon can hold the shank of the balloon catheterand the guide wire side by side (or one behind the other in non-monorailsystems) for manipulation by his/her hands at the proximal end of theguide catheter.

As the ballooning or other catheter treatment proceeds, the catheter mayhave to be withdrawn completely from the guide catheter for replacement,for example. When this is done, it is important for the guide wire to beheld—despite the withdrawal of the balloon catheter—in the position ithas attained in order to keep the attained location within reach.Withdrawing the (balloon) catheter is unproblematic, initially, and isaccomplished by simply holding the guide wire by one hand andwithdrawing the shaft of the (balloon) catheter by the other hand untilthe guide wire entry opening in the (balloon) catheter shank has reachedthe proximal end of the guide catheter. In the final portion of thedistance, in which the guide wire extends within the shank (e.g. of aballoon catheter used in angioplasty), this process calls for a specialtechnique to keep the wire from being accidentally withdrawn togetherwith the (balloon) catheter. What this means is that the guide wire(because of its low resistance to buckling) has to be advanced step bystep against the (balloon) catheter to the extent that the distal end ofthe latter (with the guide wire centrally extending therethrough) iswithdrawn from the guide catheter. This procedure is relativelycumbersome and time consuming and requires the surgeon to pay utmostattention to what he/she is doing.

SUMMARY OF THE INVENTION

For the reasons outlined above, the object of the present invention isto provide structure which simplifies the difficult withdrawal of thecatheter over a positioned guide wire.

A device of this kind is characterized by the features specified in thecharacterizing portion of patent claim 1.

One advantage of the inventive solution is that it substantiallyfacilitates the surgeon's controlling the wire movement, i.e. theadvancing movement of the wire and its simultaneous controlled rotation.It the same time, it is easier for the surgeon to distinguish the wirefrom the catheter shank so that both are easier to recognize and tohandle, which is eminently important for rapid and safe treatment. Theinventive device is equally suited for simplification and the improvedwithdrawal of coaxial wire-type catheters and so-called “monorail”catheters (wire preferably outside the cather shank) in a broad varietyof catheter examinations of any organ system. It also facilitates thesingle-handed performance of such treatments, if it does not make thempossible in the first place.

BRIEF DESCRIPTION OF THE DRAWING

FIG. 1 is a side view of a conventional situation in which an inventivedevice is to be used on a patient.

FIG. 2 is a perspective view of a preferred embodiment of the inventivedevice.

DETAILED DESCRIPTION OF THE INVENTION

The inventive device comprises a basic body adapted to be placed overguide wire 6. The body has a preferably central lumen 10 for receivingguide wire 6 and clamping means therefor, with body 9 having at itsdistal end a cannula-like extension 11, which may be telescoping ifdeemed necessary. The extent to which said cannula-like extension shouldbe collapsible in telescope fashion corresponds in the case of amonorail catheter, for example, approximately to the length in which theguide wire extends centrally within the shank of the balloon catheter atthe distal end thereof; that is, it corresponds to the distance betweenthe entrance opening of the guide wire in the balloon catheter shank andits distal exit opening. The telescoping fashion of the cannula-likeextension may be biased to extend by resilent pressure exerted by ameans such as mechanical spring or gas. The compression of thecannula-like extension occurs through the succesive sliding ofoverlapping concentric tubular segments of the cannula-like extension11. The length of the telescoping section may vary, however, dependingon the specific diagnostic and therapeutic use to which the catheter isto be put. In its simplest form, the body may be force-locked to theguide wire by means of a knurled screw 13 or the like which exertspressure on guide wire 6 extending centrally through basic body 9, thusclamping the wire against the opposite wall. In another embodiment, thisclamping action may be provided by means operating in the manner of aconventional chuck of the kind used on power tools or lathes.

In a further embodiment, this clamping action may be actuated by a leverarm mounted on the basic body. When the lever arm is actuated, the leverarm releases the clamping means thereby clamping the guide wire. Thisactuation may also result in the release of the cannula-like extensionfor longitudinal movement relative to the basic body. When the lever armis actuated again, the clamping means may release the clamping of theguide wire.

FIG. 1 of the drawing shows the conventional situation in which aninventive device is to be used on a patient, with both the guidecatheter 2 and the guide wire 6 actually being much longer than shown inthe drawing so as to be advanced to a patient's heart or other internalorgan. As can be seen in the situation shown in FIG. 1, the ballooncatheter cannot be withdrawn further from guide catheter 2 without atthe same time withdrawing guide wire 6 because the latter extends insidethe balloon catheter in the distal end portion thereof (shown inphantom). As the guide wire should maintain the position it has reachedinside the heart or any other organ (see arrow A) even if a device suchas balloon catheter 3 is withdrawn further, it is necessary for guidewire 6 to be advanced to the same extent as the balloon cather is beingwithdrawn. This process is difficult and error-prone, and it is theobject of the present invention to improve on it. Such improvement isattained, for example, by the embodiment of the inventive device 1 shownin FIG. 2 in which guide wire 6 is placed before (balloon) catheter 3, 4is withdrawn. As shown, the depicted embodiment of device 1 comprises an(elongated) basic body having a cannula-like extension 11 collapsible intelescope fashion, with means being provided to clamp guide wire 6 inposition within body 9 (in a manner not shown in detail) so as to lockguide wire axially and circumferentially to body 9 as needed.

The expanded tip 12 at the end of the cannula-like extension 11 isexpanded in an olive or mushroom shape so as to prevent its entry intothe guide cathter 2. The expanded tip 12 may further have acrescent-shaped lateral recess for conformance with the shank of thebaloon catheter 4.

Once the guide wire is locked in place, (balloon) catheter 3, 4 can bewithdrawn from guide catheter 2 until the situation shown in FIG. 2 isreached once again, namely, that the point of balloon catheter isreached where guide wire 6 exits from balloon catheter 3, 4 (exit pointB) and both exit jointly from guide catheter 2. In order to enable the(balloon) catheter to be further withdrawn from guide catheter 2 now,without guide wire 6 moving relative to the organ under treatment, thedistal extension 11 or telescoping nose is collapsed to the extent thatthe extreme end of the (balloon) catheter is withdrawn further fromguide catheter 2 so that ultimately no axial relative displacement ofguide wire 6 takes place. Thereafter, the clamping lock of the guidewire in body 9 of the inventive device may be released (e.g. byactuating a lever arm) and device 1 be withdrawn from guide wire ormoved along it, if desired. As a result, the novel device of the presentinvention improves, facilitates and accelerates the handling of thecatheterizing process in its entirety, thus rendering it much safer.

In an alternative embodiment not shown in the drawing, thewire-receiving lumen of the of the device in its entirety—including body9—has a lateral opening in the form of a longitudinally extendingstraight-line or undulating or spiralling slot. As a result, it is notnecessary for wire 6 to be axially inserted end first into lumen 10;instead, it can be placed laterally through the aforesaid slot, so thatthe handling of the device is facilitated in certain applications.

What is claimed is:
 1. A device for improving the handling of a catheterguide wire comprising: a body having a proximal end and a distal end,wherein a wire receiving lumen extends longitudinally therethrough forreceiving a guide wire, a clamping means for clamping a guide wireinside the longitudinally extending lumen, and a tubular extensionprojecting from the distal end of the body in the direction of thelongitudinally extending lumen, wherein the tubular extension is adaptedto be moved longitudinally relative to the body segment, and wherein thetubular extension is collapsible telescopically; and the wire receivinglumen extending longitudinally through the tubular extension to a distalopening defined by the tubular extension; and wherein the distal openingis sized to allow insertion of a guide wire into the wire receivinglumen and the wire receiving lumen is sized to allow a guide wire toextend through the device.
 2. Device as in claim 1, wherein the clampingmeans is provided at the proximal end of the body segment.
 3. A devicefor improving the handling of a catheter guide wire comprising: a bodyhaving a proximal end and a distal end, wherein a wire receiving lumenextends longitudinally therethrough for receiving a guide wire, aclamping means for clamping the guide wire inside the longitudinallyextending lumen, and a tubular extension projecting from the distal endof the body in the direction of the longitudinally extending lumen,wherein the tubular extension is adapted to be moved longitudinallyrelative to the body segment, and wherein the tubular extension iscollapsible telescopically; and wherein the body has a sheet clamp,wherein the sheet clamp attaches to a sheet or drape.